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Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Use a systematic approach and always follow the same sequence during examination. We usually start the palpation from the midline, i.e., the sternoclavicular joint. An increase in temperature, tenderness, or step deformities can be identified. This is followed by palpation of the suprasternal notch, sternocleidomastoid muscle, and the first rib. Palpate the costochondral junctions if suspecting costochondritis or Teitze syndrome. Next, both clavicles are palpated. At the concavity of the clavicle, palpate the coracoid a finger’s breadth below the clavicle. Be gentle in doing this because even the normal coracoid may be a bit tender on palpation. Always compare with the opposite side.
Safe Thyroidectomy
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Madan Laxman Kapre, Sankar Viswanath, Rajendra Deshmukh, Neeti Kapre Gupta
Incision: Ideally, it is marked up in the sitting position in a suitable skin crease before anesthesia. It is generally placed two-fingers breadth above the suprasternal notch or midway between the cricoid prominence and suprasternal notch. The width of the incision is tailored according to the size of the thyroid, rarely beyond the sternocleidomastoid muscle and equal on either side (Figure 8.6).
General history and examination
Published in Shahed Yousaf, Medical Examination Made Memorable (MEMM), 2018
Check the position of the trachea (tip of two fingers in the suprasternal notch). If there is extension of the thyroid mass below the suprasternal notch and the trachea is obscured then the thyroid cartilage must be examined. If there is a mass displacing the trachea it will tilt the thyroid cartilage laterally.
Comparison of the supraglottic airway device BlockBusterTM and laryngeal mask airway Supreme in anaesthetised, paralyzed adult patients: a multicenter randomized controlled trial
Published in Expert Review of Medical Devices, 2022
Xue Gao, Ju-Hui Liu, Chun-Mei Chen, Yong Wang, Zhong-Yu Wang, Chun-Ling Yan, Ming-Zhang Zuo, Yu Cao, Xin Qiao, Ya-Qi Huang, Pei-Chang Liu, Hui Zhang, Jia-Qiang Zhang, Jun-Mei Shen, Chao Li, Yi Wang, Yan-Yan Sun, Jian-Nan Song, Xi-Zhe Zhang, Yun-Long Zhang, Xiao-Ting Luo, Lu-Nan Wu, Ye Zhang, Li Shi, Yuan Zhang, Fu-Shan Xue, Ming Tian
The purpose of our multicenter randomized controlled clinical trial from 13 medical centers in China was to determine the performance of SAD BlockBusterTM in anesthetized, paralyzed adult patients by comparing it with the widely used LMA Supreme in the current practice. The main findings of this study were that the two devices were easy and quick to insert, with a high overall success rate of insertion. However, the SAD BlockBusterTM was superior to the LMA Supreme in terms of OLP, success rate of insertion at the first attempt, fiberscopic view grading, and rate of satisfactory positioning. The success rate of suprasternal notch test was significantly higher with the LMA Supreme than with the SAD BlockBusterTM, but duration and overall success rate of device insertion, success rate of gastric tube insertion, use of airway manipulations required to correct device malposition, and the occurrence of intraoperative and postoperative adverse airway events were not significantly different between the two studied devices. These results indicate that the clinical effectiveness and safety of SAD BlockBusterTM are at least not inferior to the LMA Supreme for airway maintenance in anesthetized, paralyzed adult patients.
Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy
Published in Logopedics Phoniatrics Vocology, 2022
Masoumeh Saeedi, Meysam Yadegari, Samira Aghadoost, Maryam Naderi
The thyroid gland is a vital hormonal gland and one of the largest endocrine organs, which plays a major role in the growth, development, and metabolism of the human body [1]. This organ is located in the neck, anterior to the trachea, between the suprasternal notch and the cricoid cartilage. It is made of two lobes that are connected by an isthmus [2]. In thyroid problems, thyroidectomy is a commonly used surgical procedure [3] and vocal dysfunction is a known complication following thyroid surgery [4]. The prevalence of voice alterations in the thyroidectomy varies from 0.77% to 13.3% and is mainly due to recurrent laryngeal nerve injury during the surgery [5,6]. However, alterations in voice quality and vocal symptoms can be observed in the absence of laryngeal nerve injuries [7,8]. Considering the voice complaints, pre- and post-thyroidectomy pre- and post-operatively, it is important to evaluate the voice and vocal symptoms.
Comparative study between multi-detector computed tomography and echocardiography in evaluation of congenital vascular rings
Published in Alexandria Journal of Medicine, 2018
Manal Hamisa, Fatma Elsharawy, Wafaa Elsherbeny, Suzan Bayoumy
All patients underwent echocardiography using (vivid 7, GE, Hortin Norway using probe 5S MHZ), patients under 4 years were sedated using chloral hydrate (1 mg/kg), patients were examined in reclining position and complete study for cardiac structure were done. The transducer is positioned at first at suprasternal notch, starting show downward angulation then sweep upward to allow identification of aortic arch position and its relation to trachea and branching of great vessels of head and neck. In left aortic arch, the first branch heads to the right and then bifurcates into right subclavian and right common carotid arteries. While in (right aortic arch with mirror-image branching) the first branch was seen to head to the left and then bifurcates into left subclavian and left common carotid arteries. An (aberrant subclavian artery) should be suspected if the first branch does not bifurcate. In (double aortic arch) if both archs are patent so we can detected them in transverse suprasternal view. From parasternal short axis- views at level of bifurcation of pulmonary artery and at supra sternal view, echocardiography can reveal continuation of pulmonary trunk to right and when we cannot see the origin of left pulmonary artery we must suggest either absence or aberrant origin of left pulmonary artery. Pulmonary sling is seen when the origin of left pulmonary artery arises from the right pulmonary artery, it is suggested when pulmonary trunk is followed to the right side. However information taken by echocardiography examination is inadequate, and also evaluation of the anatomy of the airways is difficult by ultrasound.